Healthcare Provider Details

I. General information

NPI: 1477540482
Provider Name (Legal Business Name): DELAWARE VALLEY MEDICAL SUPPLY
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/04/2005
Last Update Date: 10/03/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

159 FAIR ST
MARGARETVILLE NY
12455-2822
US

IV. Provider business mailing address

PO BOX 847
MARGARETVILLE NY
12455-0847
US

V. Phone/Fax

Practice location:
  • Phone: 718-796-7555
  • Fax: 516-566-2395
Mailing address:
  • Phone: 718-796-7555
  • Fax: 516-566-2395

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code332BX2000X
TaxonomyOxygen Equipment & Supplies (DME)
License Number
License Number State

VIII. Authorized Official

Name: MRS. RACHEL LEBOWICZ
Title or Position: OWNER
Credential:
Phone: 718-796-7555